The Health Care Research and Health Policy Fellowship at Stanford is designed to provide pre- and post-doctoral trainees with the skills needed to make major contributions to health care research. The program draws upon Stanford's heritage of interdisciplinary health care and health policy research and an increased institutional focus on the subjects of the program. The training program will prepare predoctoral and postdoctoral trainees for academic careers in health policy research and such related disciplines as health economics, medical informatics, clinical epidemiology, technology assessment, guidelines development, biostatistics, and medical informatics. The proposed program continues the current goals of enabling its graduates to: 1) acquire competence in the methodological tools of health services research; 2) familiarize themselves with current and emerging issues in health policy research; 3) learn about the systems and institutional structures in which health care is delivered in the United States; 4) learn to function effectively as part of a collaborative group. The central features of the existing program--a combination of formal classroom instruction and research experience obtained under the close supervision of one or more faculty members--will remain under the proposed renewal. Support will usually be offered for three years, and training will lead to either a doctoral or masters degree in a field related to health-care research. Key changes in the training reflect growing strengths in the faculty' in the areas of health economics and epidemiology, along with goals that have assumed new importance: increasing the involvement of faculty with expertise in epidemiology, quality of life measurement, and preference assessment; and increasing the number of trainees whose clinical backgrounds are in areas that have traditionally not been heavily represented in health services research. Program faculty are drawn from the Schools of Medicine, Humanities and Sciences, Business, Education, and Engineering at Stanford. The research environment includes extensive library and computational facilities, trainees in closely related programs at Stanford and the Palo Alto VA Medical Center, and a number of ongoing major research projects that are expected to provide data and resources for trainee projects.